HTMLPDF | 182-530-1000 | Outpatient drug program—General. |
HTMLPDF | 182-530-1050 | Definitions. |
HTMLPDF | 182-530-1075 | Requirements—Use of tamper-resistant prescription pads. |
HTMLPDF | 182-530-1080 | Requirements for prescribing and dispensing controlled substances—Prescription monitoring program (PMP). |
COVERAGE |
HTMLPDF | 182-530-2000 | Covered—Outpatient drugs, devices, and drug-related supplies. |
HTMLPDF | 182-530-2100 | Noncovered—Outpatient drugs and pharmaceutical supplies. |
AUTHORIZATION |
HTMLPDF | 182-530-3000 | When the medicaid agency requires authorization. |
HTMLPDF | 182-530-3100 | How the medicaid agency determines when a drug requires authorization. |
HTMLPDF | 182-530-3200 | The medicaid agency's authorization process. |
QUALITY OF CARE |
HTMLPDF | 182-530-4000 | Drug use review (DUR) board. |
HTMLPDF | 182-530-4050 | Drug use and claims review. |
HTMLPDF | 182-530-4100 | Medicaid preferred drug list (medicaid PDL). |
HTMLPDF | 182-530-4125 | Generics first for a client's first course of treatment. |
HTMLPDF | 182-530-4150 | Therapeutic interchange program (TIP). |
BILLING |
HTMLPDF | 182-530-5000 | Billing requirements—Pharmacy claim payment. |
HTMLPDF | 182-530-5050 | Billing requirements—Point-of-sale (POS) system/prospective drug use review (Pro-DUR). |
HTMLPDF | 182-530-5100 | Billing requirements—Unit dose. |
MAIL-ORDER SERVICES |
HTMLPDF | 182-530-6000 | Mail-order and specialty pharmacy services. |
REIMBURSEMENT |
HTMLPDF | 182-530-7000 | Reimbursement. |
HTMLPDF | 182-530-7050 | Reimbursement—Dispensing fee determination. |
HTMLPDF | 182-530-7100 | Reimbursement—Pharmaceutical supplies. |
HTMLPDF | 182-530-7150 | Reimbursement—Compounded prescriptions. |
HTMLPDF | 182-530-7200 | Reimbursement—Out-of-state prescriptions. |
HTMLPDF | 182-530-7250 | Reimbursement—Miscellaneous. |
HTMLPDF | 182-530-7300 | Reimbursement—Requesting a change. |
HTMLPDF | 182-530-7350 | Reimbursement—Unit dose drug delivery systems. |
HTMLPDF | 182-530-7400 | Reimbursement—Compliance packaging services. |
HTMLPDF | 182-530-7500 | Drug rebate requirement. |
HTMLPDF | 182-530-7600 | Reimbursement—Clients enrolled in managed care. |
HTMLPDF | 182-530-7700 | Reimbursement—Dual eligible clients/medicare. |
HTMLPDF | 182-530-7800 | Reimbursement—Clients with third-party liability. |
HTMLPDF | 182-530-7900 | Drugs purchased under the Public Health Service (PHS) Act. |
REIMBURSEMENT METHODOLOGY |
HTMLPDF | 182-530-8000 | Reimbursement method—Actual acquisition cost (AAC). |
HTMLPDF | 182-530-8050 | Reimbursement—Federal upper limit (FUL). |
HTMLPDF | 182-530-8100 | Reimbursement—Maximum allowable cost (MAC). |
HTMLPDF | 182-530-8150 | Reimbursement—Automated maximum allowable cost (AMAC). |